Screening and Education; Most People With STDs Never Show Symptoms, and Annual Physical Exams Donít Test for Them

From CDC National Prevention Information Network

November 11, 2002

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The American Social Health Association estimates as many as one in five Americans has an STD, and that one in four Americans will contract an STD in their lifetime. The most common misconception by far is that STDs cause symptoms, said Dr. Mark Pearlman, vice chair of the obstetrics/gynecology department at the University of Michigan Health System. About two-thirds of those who are affected have no symptoms. For instance, he says, 80 percent of those with genital herpes -- an affliction most assume has obvious warning signs -- do not know they have an STD. The second misconception is that STDs strike only a certain class of people. Theyre equal-opportunity infectors, he said.

Sonji Lynn Trent, director of education and training for Planned Parenthood of Southeast Michigan, said she often has to correct young adults who think they cannot contract an STD through oral sex or during their first sexual encounter. Another common misconception among women is that an annual gynecological exam will detect STDs. Some doctors may do screening in addition to the Pap smear test as part of an annual exam, but there is no standardized battery of tests automatically performed to rule out all STDs.

At UMHS, women who know little about their partner's sexual history are often screened for STDs such as chlamydia and gonorrhea, Pearlman said. Women typically have to ask for further testing, unless they test positive for those two STDs. Women who have had more than one sexual partner in the last year or women who have one STD or dont know their sex partner well should be screened for other STDs, he said.

Women who come to PPSM for an annual exam are automatically given a Pap smear as well as screening for gonorrhea and chlamydia. If either test is positive, or if their sexual history points to risky behaviors, doctors typically screen for other STDs, such as syphilis. Screenings for HIV are also done at a patients request.

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